Caribbean - IBFAN

YOU can be a monitor and help
protect infant health!!!
IBFAN continuously compiles violations and welcomes your input.
Have you noticed any company practices lately which violate the International Code or subsequent
resolutions? Or which discourage breastfeeding? If so, help us collect the information by photocopying and
completing the form below and sending it to –
IBFAN-ICDC, P.O Box 19, 10700 Penang, Malaysia. E-mail: ibfanpg@tm.net.my
The above information is necessary to enable IBFAN-ICDC to double-check the information you
have given, if necessary. Your identity will be kept confidential.
Description of Code violation (please answer all questions, especially the when, where, who, what and how)
1. Short Description .................................................................................................................................
(Include heading or slogan found on company materials.)
2. When was the violation observed? (dd/mm/yyyy) ..............................................................................
3. Where? (place, city and country) ........................................................................................................
(For newspapers and periodicals, please indicate the name and date of publication.)
4. Who is violating the Code and how?
1 Type of product: A. Infant formula, B. Follow-up formula, C. Complementary food, D. Bottle & Teat, E. Other (please specify)
If specimen or picture is attached, tick here
MONITORING THE CODE
Name .............................................................................
Address .........................................................................
E-mail ...........................................................................
� � � � � � � � � �
5. Observation / Details (Please use another sheet of paper if necessary):
Which IBFAN group, if any:
.......................................................
.......................................................
Company Brand Type of product 1 Type of violation 2
2Type of violation: A. Advertisement, B. Commercial promotion in health facility, C. Company contact with mothers,
D. Donation of products to health facilities, E. Free sample, F. Gift to health worker, G. Gift to mother, H. Inadequate labelling,
I. Promotion in shops, J. Sponsorship, K. Other (please explain, use another sheet of paper if necessary)
• This form may be returned to IBFAN/ICDC by post or via email as a Word, PDF or JPEG file. An electronic version of
this form can be obtained from IBFAN/ICDC at ibfanpg@tm.net.my or can be downloaded from the IBFAN website at
www.ibfan.org
• Where possible, include actual specimen, photographs or scanned images of Code violations with your form.
• Samples should be identified and matched to the correct forms, especially when you do more than one report.
Thank you!
Together we are strong.